Primary carcinoid tumour in horseshoe kidney

Primary renal carcinoid tumours are extremely rare. To date, approximately 60 cases have been reported, mostly as case reports with only few series noted. The pathogenesis of this tumour is uncertain because neuroendocrine cells are not found in normal adult renal parenchyma. We report a case of primary renal carcinoid occurring in a horseshoe kidney in a 66-year-old patient. A clinical, histological and immunohistochemical picture of this tumour is presented

Causes of death and morbidity in patients with atrial fibrillation after left atrial appendage occlusion

Background: Left atrial appendage occlusion (LAAO) is a safe and effective alternative for stroke prevention in patients with atrial fibrillation (AF). However, there is little literature on the exact causes of death and adverse events during follow‑up after LAAO. Aims: The primary aim of this study was to evaluate survival free of any serious adverse events and of any‑cause death in midterm follow‑up. The secondary aims were to analyze causes of mortality and further hospitalization as well as adverse events, thromboembolism, and bleeding risk reduction during follow‑up. Methods: A retrospective, single‑center study was performed in 84 consecutive patients with AF who underwent LAAO with endocardial occluders. The mean (SD) CHADS2 score was 3.5 (1.1), CHA2DS2‑VASc score, 5.0 (1.5), and HAS‑BLED score, 4.4 (0.9). After LAAO, dual 6‑month antiplatelet therapy and then lifelong aspirin monotherapy was recommended. Mean (SD) follow‑up was 25.3 (13.2) months with an accumulated total follow‑up of 174.6 patient‑years. Results: The annual mortality rate was 12.02%. More than half of deaths (57%) were due to noncardiovascular causes with leading malignancy. Survival at the end of the periprocedural period was 98.8%, at 3 months, 97.6%, at 6 months, 95.2%, at 12 months, 86.5%, at 18 months, 85.1%, and at 24 months, 80.6%. The average annual thromboembolic event rate was 2.87%. The most common adverse event was severe bleeding with an annual rate of 6.3% (3 cases while receiving dual antiplatelet therapy and 6 cases while receiving aspirin). Conclusions: The majority of deaths were not related to stroke in patients with AF after LAAO. Mortality in first 2 years following the procedure was predominantly from noncardiovascular causes

Giant left atrium associated with massive thrombus formation 14 years after orthotopic heart transplantation

Abstract We report the case of a 60-year-old patient who underwent orthotopic heart transplant 14 years earlier. Routine echocardiography showed giant masses in the left atrium. There were no symptoms or thromboembolic events in the past. Magnetic resonance imaging study revealed very enlarged left atrium (8.7 × 10.6 cm) occupied by irregular smooth mass (7 × 5 × 6.1 cm) with a stalk that was attached to the posterior left atrial wall in the area of graft suture lines. Intraoperative examination revealed a massive thrombus (12 × 10 cm) that filled almost the entire left atrial area